WAIVER AND RELEASE OF LIABILITY

In consideration of the risk of injury while participating in EFC Chino Valley Labor Day Weekend Retreat (the
Activity), and as consideration for the right to participate in the Activity, I hereby, for myself, my heirs,
executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver
and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever
arising out of my participation in the Activity, and do hereby release and forever discharge EFC Chino Valley,
located at 973 E. Phillips Blvd, Pomona, California 91766, their affiliates, managers, members, agents,
attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or
psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional
loss, that I may suffer as a direct results of participation in the aforementioned Activity, including traveling to
and from an event related to this Activity.
I am voluntarily participating in the aforementioned Activity and I am participating in the Activity entirely at
my own risk. I am aware of the risks associated with traveling to and from as well as participating in this
Activity, which may include, but are not limited to, physical or psychological injury, pain, suffering, illness,
disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and death. I
understand that these injuries or outcomes may arise from my own or others negligence, conditions related to
travel, or the condition of the Activity location(s). Nonetheless, I assume all related risks, both known or
unknown to me, of my participation in this Activity, including travel to, from and during this Activity.
I agree to indemnify and hold harmless EFC Chino Valley against any and all claims, suits or actions of any
kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf,
including attorneys fees and any related costs, if litigation arises pursuant to any claims made by me or by
anyone else acting on my behalf. If EFC Chino Valley incurs any of these types of expenses, I agree to
reimburse EFC Chino Valley.
I acknowledge that EFC Chino Valley and their directors, officers, volunteers, representatives and agents are not
responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or
activity on behalf of EFC Chino Valley.
I acknowledge that this Activity may involve a test of a persons physical and mental limits and may carry with
it the potential for death, serious injury, and property loss. The risks may include, but are not limited to, those
caused by terrain, facilities, temperature, weather, lack of hydration, condition or participants, equipment,
vehicular traffic and actions of others, including but not limited to, participants, volunteers, spectators, coaches,
event officials and event monitors, and/or producers of the event.
I acknowledge that I have carefully read this waiver and release and fully understand that it is a release of
liability. I expressly agree to release and discharge EFC Chino Valley and all of its affiliates, managers,
members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, from
any and all claims or causes of action and I agree to voluntarily give up or waive any right that I otherwise have
to bring a legal action against EFC Chino Valley for personal injury or property damage.
To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence
on the part of EFC Chino Valley, its agents, and employees.
In the event that I should require medical care or treatment, I agree to be financially responsible for any costs
incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.

In the event that any damage to equipment or facilities occurs as a result of my or my familys willful actions,
neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any
actions or neglect or recklessness.
This Agreement was entered into at arms-length, without duress or coercion, and it to be interpreted as an
agreement between two parties of equal bargaining strength. Both the Participant(s) and EFC Chino Valley
agree that this Agreement is clear and unambiguous as to its terms, and that no other evidence will be used or
admitted to alter or explain the terms of this Agreement, but that it will be interpreted based on the language in
accordance with the purposes for which it is entered into.
In the event that any provision contained within this Release of Liability shall be deemed to be severable or
invalid or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or
otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the
clause severed does not affect the intent of the parties. If a court should find that any provision of this agreement
to be invalid or unenforceable, but that by limited said provision it would become valid and enforceable, then
said provision shall be deemed to be written, construed and enforced as so limited.
I, the undersigned participant, affirm that I am the age of 18 years or older, and that I am freely signing this
agreement. I certify that I have read this agreement, that I fully understand its content and that this release
cannot be modified orally. I am aware that this is a release of liability and a contract that I am signing of my
own free will.
Participants Name:
_____________________________________________________________________
Participants Address: _____________________________________________________________________
Signature:
Date:

____________________________________________________________________________
____________________________________________________________________________

NOTE: Each Attendee who is an adult (over the age of 18) must sign this Release and Registration Form. Any
of Your Family Members who are minors (under the age of 18) attending the Activity must be listed below.
Family Member Information:
Your Family Members Information (including Name(s) of Your Family Members who are minors (under the
age of 18) on whose behalf this Release and Registration Form is signed and on whose behalf permission is
given by You or Your Adult Spouse/Significant Other to attend the Activity):
Spouse/ Significant Other:
First Name:__________________________ Last Name:____________________________ Age (if under
18)_________
_________________ _______ _________________________Date: __________ 2015
Adult Spouse/Significant Other signature (if over the age of 18)
-------------------------------------------------------------------------------------------------------------------------------------------------------------FAMILIES WITH MEMBERS UNDER THE AGE OF 18
In the event that the participant has family members participating in the aforementioned Activity, and is under
the age of consent (18 years of age), then this release must be signed by a parent or guardian, as follows:
I hereby certify that I am the parent or guardian of the child(ren), named below, and do hereby give my consent
without reservation to the foregoing on behalf of this individual.

Child (1):
First Name: __________________________ Last Name:_____ _______________________ Age:___________
_____________________________________________________________________ Date: __________ 2015
Parent/Legal Guardian signature (if under the age of 18)/Childs signature (if over 18)
Child (2):
First Name: ___________________________ Last Name: ____________________________ Age:_________
____________________________________________________________________ Dated: _________ 2015
Parent/Legal Guardian signature (if under the age of 18)/Childs signature (if over 18)
Child (3):
First Name: ___________________________ Last Name: ____________________________ Age:_________
____________________________________________________________________ Dated: __________2015
Parent/Legal Guardian signature (if under the age of 18)/Childs signature (if over 18)
Child (4):
First Name: ___________________________ Last Name: ____________________________ Age:_________
____________________________________________________________________ Dated: __________2015
Parent/Legal Guardian signature (if under the age of 18)/Childs signature (if over 18)
Family Emergency Contact:
In the event of an emergency, please contact the following person(s) in the order presented:
Emergency Contact : ____________________________
Contact Relationship : ___________________________
Contact Telephone : _____________________________